| NPI | 1952887226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: DC RN500013647) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC hha13836) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2024-01-16 |